L6100 HCPCS code: Below elbow, molded socket, flexible elbow hinge, triceps pad
L6100 is the HCPCS Level II code for below elbow, molded socket, flexible elbow hinge, triceps pad. The 2026 Medicare DMEPOS fee schedule pays $1,414.34 to $3,141.59 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers. Medicare volume fell 26% from 2022 to 2024 (81 to 60 services). In 2024, 49 suppliers billed Medicare for L6100 (purchases), serving 54 beneficiaries. Its average fee ranks 1 of 4 L61 codes (family range $2,650.46–$3,584.15).
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1982-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L6100
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,414.34 | $3,141.59 | $3,141.59 | $2,356.19 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,588.25 | — |
| AL | — | $2,356.19 | — |
| AR | — | $2,890.34 | — |
| AZ | — | $2,572.24 | — |
| CA | — | $2,572.24 | — |
| CO | — | $2,477.17 | — |
| CT | — | $2,592.57 | — |
| DC | — | $2,356.19 | — |
| DE | — | $2,356.19 | — |
| FL | — | $2,356.19 | — |
| GA | — | $2,356.19 | — |
| HI | — | $2,767.65 | — |
| IA | — | $2,883.00 | — |
| ID | — | $2,862.95 | — |
| IL | — | $3,097.46 | — |
| IN | — | $3,097.46 | — |
| KS | — | $2,883.00 | — |
| KY | — | $2,356.19 | — |
| LA | — | $2,890.34 | — |
| MA | — | $2,592.57 | — |
| MD | — | $2,356.19 | — |
| ME | — | $2,592.57 | — |
| MI | — | $3,097.46 | — |
| MN | — | $3,097.46 | — |
| MO | — | $2,883.00 | — |
| MS | — | $2,356.19 | — |
| MT | — | $2,477.17 | — |
| NC | — | $2,356.19 | — |
| ND | — | $2,477.17 | — |
| NE | — | $2,883.00 | — |
| NH | — | $2,592.57 | — |
| NJ | — | $3,141.59 | — |
| NM | — | $2,890.34 | — |
| NV | — | $2,572.24 | — |
| NY | — | $3,141.59 | — |
| OH | — | $3,097.46 | — |
| OK | — | $2,890.34 | — |
| OR | — | $2,862.95 | — |
| PA | — | $2,356.19 | — |
| PR | — | $1,414.34 | — |
| RI | — | $2,592.57 | — |
| SC | — | $2,356.19 | — |
| SD | — | $2,477.17 | — |
| TN | — | $2,356.19 | — |
| TX | — | $2,890.34 | — |
| UT | — | $2,477.17 | — |
| VA | — | $2,356.19 | — |
| VI | — | $3,141.59 | — |
| VT | — | $2,592.57 | — |
| WA | — | $2,862.95 | — |
| WI | — | $3,097.46 | — |
| WV | — | $2,356.19 | — |
| WY | — | $2,477.17 | — |
How the L6100 fee compares
| Measure | Value |
|---|---|
| Rank among 4 L61 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $2,650.46–$3,584.15 |
| Rural fee uplift | — |
Who bills L6100 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 49 |
| Referring clinicians | 54 |
| Medicare beneficiaries | 54 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 71 | 72 |
| 2023 | 82 | 86 |
| 2024 | 49 | 54 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L6100, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 81 | 72 | $2,364.81 | $1,837.62 |
| 2023 | 99 | 86 | $2,526.73 | $1,972.18 |
| 2024 | 60 | 54 | $2,615.96 | $2,009.41 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
What changed for L6100
- 2026-01-01: Average state fee rose 2.0%: $2,598.49 to $2,650.46
- 1982-01-01: L6100 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L6100?
L6100 is the HCPCS Level II code for below elbow, molded socket, flexible elbow hinge, triceps pad. Short descriptor: "Elb mold sock flex hinge pad".
How much does Medicare pay for L6100?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,414.34–$3,141.59. Rural fees can be higher.
Does Medicare cover L6100?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6100 change in 2026?
The average non-rural state fee moved from $2,598.49 in 2025 to $2,650.46 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6100 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L61 codes
- L6110 — Below elbow, molded socket, (muenster or northwestern suspension types) ($1,431.47–$3,721.84)
- L6120 — Below elbow, molded double wall split socket, step-up hinges, half cuff ($1,533.73–$4,181.56)
- L6130 — Below elbow, molded double wall split socket, stump activated locking hinge, half cuff ($1,564.55–$5,581.92)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L6100
- Watch L6100 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6100
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.